Archive for September, 2011

Even though the inflation rate in Massachusetts is expected to increase 1.6%, health insurance premiums are increasing by as much as 10%. The VP of Blue Cross Blue Shield says that their premium increases are actually at the lowest levels since 2005, but notes that the increases are still not acceptable or sustainable. Their increases will range from 4 to 6%, Tufts Health Plan will increase premiums 5 to 8%, and Harvard Pilgrim Health Care plans 5 to 10% increases. This information comes from Boston’s NPR news station’s article, “Mass. Health Insurance Premiums On the Rise,” by Martha Bebinger.

Harvard Pilgrim says that increases aren’t as high as they have been for two reasons. One is that health insurance companies have been negotiating deals with doctors and hospitals because they are all under pressure to lower costs. The other is that people are getting fewer procedures and using their health insurance less in many cases. This may be because they are scared of losing their jobs if they miss work, but it could also be due to the fact that they have to pay a lot out of pocket before their insurance pays the rest.

High deductible health plans have become much more prevalent lately as insurance companies, doctors and hospitals work to cut costs. Consumers who compare health insurance quotes find that these high deductible plans are helpful in saving money and ensuring people aren’t getting any unnecessary procedures. Not everyone thinks that all of the responsibility for lowering costs should be put on insurance companies and health care providers though. Many consumer groups want the state to step in and set prices that insurers and health care providers have to follow. Whether the state steps in or insurance companies can lower prices on their own remains to be seen.

Cuts to Medicaid are proposed in both President Obama’s debt reduction plan and a current House bill sponsored by Rep. Paul Ryan of Wisconsin. According to Jay Greene of Crain’s Detroit Business, a study by The Lewin Group and Families USA showed that 120,000 kids in Michigan with lung disease could be devastated by these cuts. In the article “Report: Medicaid cuts could seriously hurt residents in Michigan with diabetes and lung disease,” Greene says that in addition to pain, suffering, and increased death, Medicaid cuts could inevitably lead to higher costs.

The third leading cause of death in the U.S., lung disease in children is most commonly associated with asthma and cystic fibrosis. There are almost 240,000 Michigan residents on Medicaid receiving care for these lung diseases as well as chronic obsessive pulmonary disease and other lung diseases. Medicaid also covers around 100,000 people fighting diabetes, which is the nation’s seventh highest cause of death. Close to 250,000 residents receive Medicaid for heart disease and stroke, as well as around 23,000 for cancer treatment. With cuts to Medicaid trickling down to states like Michigan, they would have no choice but to deny Medicaid to some people.

Over the next decade, cuts have been proposed between $15 and $771 billion for Medicaid. These cuts could reduce state funding by 30% and force those with less serious cases to stop receiving Medicaid altogether. Residents would have to compare lower cost health insurance alternatives like Go Blue Florida, which helps residents of that state. Until it is mandatory for health insurance companies to cover those with preexisting conditions however, many of those suffering from lung disease or diabetes might be forced to go without insurance. That would be devastating to everyone involved, especially sick kids.

Maybe some companies are trying to get their denials in before health care reform takes effect in 2014, but many are issuing health insurance denials at an all-time high level. According to a USA Today article by Phil Galewitz of Kaiser Health News, “Health insurance denial rates (are) routinely 20%, data show.” Companies like Aultcare health insurance work hard to keep their denials for health insurance coverage low, but it can be hard when more and more applicants have pre-existing conditions related to obesity and other seemingly manageable conditions.

America’s Health Insurance Plans (AHIP) found data in 2009 suggesting that 87% of Americans who apply for individual health insurance are accepted. That figure does include those who are denied their original request and are given an alternate plan or charged more for insurance than they thought. Current information shows that more than 20% of applicants are denied coverage for a wide range of reasons. Different health insurance companies have different denial rates state by state and each state has a large variation in the denial rates of different companies. Aetna denies 15% of applicants in Georgia, while Kaiser Permanente denies 47% of applicants in the same state.

The highest denial rate of 70% went to John Alden health insurance, a branch of Assurant Health. Assurant points out that these statistics can be a bit misleading, however. The denial rate includes applicants who are offered a plan in which they qualify for an additional cost and those who apply, but are out of the company’s coverage area. Regardless of the reason for the denial, many Americans are having a hard time finding individual health insurance and have high hopes that the 2014 ban of denying coverage for pre-existing conditions will really help them. Click here to see if you qualify for the individual health insurance of your choice.

Health insurance companies are closely monitoring proposed legislation to allow fast food restaurants to accept food stamps as a form of payment. According to USA Today’s article “Restaurants want a piece of food stamp pie,” one-third more businesses accepted food stamps in 2010 than did in 2005. Authors Jonathan Ellis and Megan Luther say that Yum! Brands is the driving force behind the push to get food stamps accepted in restaurants. Their restaurants are not typically considered healthy so many health insurance companies worry that this could also lead to an increase in the already high obesity rates of the nation. Taco Bell, KFC, Pizza Hut, and Long John Silvers are part of the YUM! Brands.

The current federal rules do not allow food stamps to be used for any food that is already prepared. Florida, Arizona, California and Michigan already follow a provision from the 1970′s, however, which allows those who are disabled, homeless, or elderly to use their food stamps in restaurants. Since $64.7 billion are given out each year in food stamps, it is easy to understand why restaurants want to get in on this business. Public health advocates and insurers worry that this will negatively affect the nation’s health and could even increase health insurance rates as obesity rates increase. Inevitably there will be much more arguing over whether restaurants should be allowed to accept food stamps from those getting government aide. Maybe there is a way to ensure that healthy food is the top choice, but that seems like a difficult thing to govern.